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Calcium chloride minimizes the hemodynamic effects of propofol in patients undergoing coronary artery bypass grafting

Authors
Publisher
Elsevier Inc.
Publication Date
Volume
13
Issue
2
Identifiers
DOI: 10.1016/s1053-0770(99)90078-2
Keywords
  • Cardiac Anesthesia
  • Coronary Artery Bypass Grafting
  • Fentanyl
  • Propofol
  • Inotropic Drugs
  • Calcium Chloride
Disciplines
  • Medicine

Abstract

Abstract Objective: To assess the hemodynamic effects of propofol and the counteracting effect of calcium chloride (CaCI 2) in patients undergoing coronary artery bypass grafting (CABG). Design: Prospective, randomized study. Setting: University hospital, department of cardiac surgery. Participants: Fifty-eight patients undergoing elective CABG, divided into group A (n = 29) and group B (n = 29). Interventions: Anesthesia was induced with a combination of fentanyl, 7 μg/kg; pancuronium, 0.1 mg/kg; and propofol, 1.5 mg/kg, administered over 60 seconds. A blinded investigator administered saline in group A patients and 10 mg/kg of CaCl 2 in group B patients at the same speed and same time as propofol administration through another lumen of the central venous catheter. Measurements and Main Results: Hemodynamic data were obtained at baseline (TO), 2 minutes after anesthesia induction (T1), and 2 minutes after tracheal intubation (T2). Heart rate decreased significantly in group A patients (86.2 ± 11.3 beats/min at TO and 72.8 ± 7.5 beats/min at T2; p < 0.001). Mean arterial pressure decreased significantly in patients in both groups (group A, 108.0 ± 12.0 mmHg at TO; 74.6 ± 14.6 mmHg at T2; p < 0.001 and group B, 106.0 ± 10.2 mmHg at TO; 90.4 ± 10.0 mmHg at T2; p < 0.05). Stroke volume index, cardiac index, and cardiac output decreased in group A patients (39.4 ± 4.1 mL/beat/m 2 at TO and 28.8 ± 5.2 mL/beat/m 2 at T2; p < 0.05; 3.4 ± 0.6 L/min/m 2 at TO and 1.9 ± 0.3 L/min/m 2 at T2; p < 0.001; 5.9 ± 0.9 L/min at TO and 3.4 ± 0.4 L/min at T2; p < 0.001, respectively), whereas in group B patients, changes were negligible (38.1 ± 7.0 mL/beat/m 2 at TO v 35.7 ± 6.6 mL/beat/m 2 at T2; (NS) 3.3 ± 0.5 L/min/m 2 at TO v 2.7 ± 0.3 L/min/m 2 at T2; (NS) 5.7 ± 0.9 L/min at TO v 4.7 ± 0.5 L/min at T2; (NS), respectively). Conclusion: Simultaneous administration of CaCl 2during the induction of anesthesia minimizes the potential negative effect of propofol on cardiac function in cardiac patients.

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